The impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cysts: a prospective clinical study of 191 patients.
OBJECTIVE
To investigate the impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cysts and the possible mechanisms.


METHODS
A prospective study.


METHODS
Obstetrics and Gynecology Department of a university hospital.


METHODS
191 patients with benign ovarian cysts undergoing ovarian cystectomy.


METHODS
Laparoscopic ovarian cystectomy using bipolar or ultrasonic scalpel electrocoagulation and laparotomic ovarian cystectomy using sutures after the excision of ovarian cysts.


METHODS
Follicle-stimulating hormone (FSH) assay and transvaginal ultrasound evaluating basal antral follicle number, mean ovarian diameter, and ovarian stromal blood flow velocity at day 3 of menstrual cycles 1, 3, 6, and 12 after surgery.


RESULTS
When comparing the bipolar group and ultrasonic scalpel group with the suture group, a statistically significant increase of the mean FSH value was found in bilateral-cyst patients at 1-, 3-, 6-, and 12-month follow-up evaluations and in unilateral-cyst patients at the 1-month follow-up evaluation. Statistically significant decreases of basal antral follicle number and mean ovarian diameter were found during the 3-, 6-, 12-month follow-up evaluations as well as statistically significant decreases of peak systolic velocity at all of the follow-up evaluations.


CONCLUSIONS
Electrocoagulation after laparoscopic excision of ovarian cysts is associated with a statistically significant reduction in ovarian reserve, which is partly a consequence of the damage to the ovarian vascular system.
Li
Chang-Zhong
CZ
Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China. Electronic address: lichangzhong@hotmail.com.
Liu
Bo
B
Department of Oncology, Shandong Tumor Hospital, Jinan, People's Republic of China.
Wen
Ze-Qing
ZQ
Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China.
Sun
Qiang
Q
School of Public Health, Shandong University, Jinan, People's Republic of China.
D000293:Adolescent; D000328:Adult; D002452:Cell Count; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods; D005260:Female; D005298:Fertility / Q000502:physiology; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000209:etiology / Q000473:pathology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D006080:Ovarian Follicle / Q000473:pathology*; D011379:Prognosis; D016896:Treatment Outcome; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging; D055815:Young Adult
D005640:Follicle Stimulating Hormone